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Articles in E-pub version are posted online ahead of regular printed publication.
Original Articles
- Comparison of combined torsional and conventional ultrasound mode versus torsional ultrasound mode phacoemulsification in different machines
- Jiyoung Emily Lee, Eun Chul Kim
- Received December 28, 2025 Accepted April 7, 2026 Published online May 21, 2026
- DOI: https://doi.org/10.63375/icrs.25.018 [Epub ahead of print]
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Abstract
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ePub - Purpose
This study aimed to compare the clinical outcomes of phacoemulsification performed using a combined torsional and conventional ultrasound mode versus torsional ultrasound mode alone in cataract surgery.
Methods
Sixty-five patients who underwent phacoemulsification using combined torsional and conventional ultrasound mode with the Cube alpha system (Nidek Co.) were compared with 300 patients who underwent phacoemulsification using torsional ultrasound mode alone with the Centurion system (Alcon Research Ltd.). The two groups were classified as N3, N4, N5, or N6 according to the Lens Opacities Classification System III. In each subgroup, phacoemulsification time (seconds), cumulative dissipated energy (CDE), balanced salt solution (BSS) use, and postoperative best-corrected visual acuity were analyzed and compared between the combined-mode group and the torsional-only group.
Results
In the N4–N6 subgroups, the torsional-only group had significantly longer phacoemulsification times and higher CDE values than the combined-mode group (P<0.05 for all comparisons). In the N3–N6 subgroups, the total volume of BSS used in the torsional-only group (N3, 30.97±11.05; N4, 48.56±20.06; N5, 68.27±23.06; N6, 125.64±45.67) was significantly greater than that used in the combined-mode group (N3, 23.01±10.27; N4, 39.03±24.16; N5, 42.86±18.24; N6, 54.75±0.75) (P<0.05). There were no statistically significant differences between the groups in postoperative manifest refraction spherical equivalent, corneal endothelial cell loss, or best-corrected visual acuity.
Conclusion
Compared with torsional ultrasound mode alone, the combined torsional and conventional ultrasound mode was more efficient in terms of ultrasound time, CDE, and BSS use. This advantage was more evident with increasing nuclear sclerosis grade.
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- Clinical outcomes of combined phacoemulsification and epiretinal membrane peeling using three advanced intraocular lens platforms
- Chan Hong Min, Jaehyuck Jo, Ho Seok Chung, Dong Yoon Kim, Jin Hyoung Park
- Received February 15, 2026 Accepted April 8, 2026 Published online May 21, 2026
- DOI: https://doi.org/10.63375/icrs.26.001 [Epub ahead of print]
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Abstract
PDFePub
- Purpose
This retrospective study evaluated the clinical outcomes of combined phacoemulsification, implantation of 1 of 3 types of advanced intraocular lenses (IOLs) with multifocality, and pars plana vitrectomy with epiretinal membrane (ERM) peeling in patients with cataract and ERM. Outcomes were compared with those in age-matched controls who underwent phacoemulsification with the same IOL alone.
Methods
A total of 70 eyes were included: 35 eyes underwent combined surgery, and 35 served as controls. In each group, 15 eyes received an advanced monofocal IOL (Tecnis Eyhance ICB00), 15 received a hybrid diffractive extended-depth-of-focus (EDoF) IOL (Tecnis Symfony ZXR00), and five received a hybrid refractive EDoF IOL (Precizon Presbyopic NVA).
Results
All groups showed significant visual improvement by 6 months postoperatively. Eyes that received hybrid diffractive EDoF IOLs and underwent combined surgery showed significantly worse mean corrected distance visual acuity, uncorrected distance visual acuity, corrected intermediate visual acuity, and corrected near visual acuity at 3 months than control eyes, but these outcomes improved to levels comparable to those of control eyes by 6 months. Eyes that received hybrid refractive EDoF IOLs showed similar early delays; however, interpretation was limited by the small sample size.
Conclusion
Overall, combined surgery was safe and effective, although early visual recovery may be delayed in eyes receiving EDoF IOLs. These findings suggest that advanced monofocal and EDoF IOLs may be considered in selected patients with ERM; however, the results should be interpreted cautiously because of the retrospective design and limited sample size.
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